Education and Research Israelite Institute Albert Einstein

São Paulo, Brazil

Education and Research Israelite Institute Albert Einstein

São Paulo, Brazil
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Silva-Neto R.P.,Federal University of Pernambuco | Peres M.F.P.,Education and Research Israelite Institute Albert Einstein | Valenca M.M.,Federal University of Pernambuco
Journal of the Neurological Sciences | Year: 2014

Our objective was to determine the accuracy parameters of osmophobia in the differential diagnosis between migraine and tension-type headache. Migraine or tension-type headache patients, diagnosed according to the criteria of the International Classification of Headache Disorders-II, were interviewed about osmophobia during the crisis and in the period between episodes. We studied 200 migraine patients and 200 tension-type headache patients. During the crisis, osmophobia occurred in 86.0% (172/200) of patients with migraine and 6.0% (12/200) of those with tension-type headache. In migraine, osmophobia was associated with photophobia and phonophobia (57/172, 33.1%) or with nausea, photophobia and phonophobia (92/172, 53.5%) and presented high sensitivity (86.0%, 95% CI 80.2-90.3) and specificity (94.0%, 95% CI 89.5-96.7), with low percentages of false positives (6.5%, 95% CI 3.6-11.4) and negatives (13.0%, 95% CI 8.9-18.4). In the period between attacks, osmophobia was restricted to migraine patients (48/200, 24.0%). The areas under ROC curves were: 0.903 ± 0.017 to osmophobia during crisis; 0.784 ± 0.025 between crises; 0.807 ± 0.023 to photophobia/phonophobia, and 0.885 ± 0.017 to pain developed by odors. Osmophobia may be a specific marker to differentiate migraine from tension-type headache, which suggests its inclusion within the criteria to diagnose migraine. © 2014 Elsevier B.V.


Silva-Neto R.P.,Federal University of Pernambuco | Peres M.F.P.,Education and Research Israelite Institute Albert Einstein | Valenca M.M.,Federal University of Pernambuco
Cephalalgia | Year: 2014

Objectives: Our objective was to determine odorants that trigger migraine attacks and the time of onset of headache after exposure. Methods: Migraine or tension-type headache patients, diagnosed according to the criteria of the International Classification of Headache Disorders-II, were interviewed about lifetime prevalence of headaches triggered by odors and time of onset of pain, after exposure of the patient to the odor. Results: We studied 200 migraine patients and 200 tension-type headache patients. There were odor-triggered headaches after 25.5±1.9 minutes of exposure in 70.0% (140/200) of migraine patients and none with tension-type headache, which ran at low sensitivity (70.0%, 95% CI 63.1-76.2) and high specificity (100.0%, 95% CI 97.6-100.0). Odor-triggered headaches are distributed in the following order of frequency: perfumes (106/140, 75.7%), paints (59/140, 42.1%), gasoline (40/140, 28.6%) and bleach (38/140, 27.1%). There was significance in the association of odor-triggered migraine, especially among perfume with cleaning (phi=-0.459), cooking (phi=0.238), beauty products (phi=-0.213) and foul odors (phi=-0.582). Conclusions: Odorants, isolated or in association, especially perfume, may trigger migraine attacks after a few minutes of exposure. © International Headache Society 2013.


PubMed | Education and Research Israelite Institute Albert Einstein and Federal University of Pernambuco
Type: Comparative Study | Journal: Journal of the neurological sciences | Year: 2014

Our objective was to determine the accuracy parameters of osmophobia in the differential diagnosis between migraine and tension-type headache. Migraine or tension-type headache patients, diagnosed according to the criteria of the International Classification of Headache Disorders-II, were interviewed about osmophobia during the crisis and in the period between episodes. We studied 200 migraine patients and 200 tension-type headache patients. During the crisis, osmophobia occurred in 86.0% (172/200) of patients with migraine and 6.0% (12/200) of those with tension-type headache. In migraine, osmophobia was associated with photophobia and phonophobia (57/172, 33.1%) or with nausea, photophobia and phonophobia (92/172, 53.5%) and presented high sensitivity (86.0%, 95% CI 80.2-90.3) and specificity (94.0%, 95% CI 89.5-96.7), with low percentages of false positives (6.5%, 95% CI 3.6-11.4) and negatives (13.0%, 95% CI 8.9-18.4). In the period between attacks, osmophobia was restricted to migraine patients (48/200, 24.0%). The areas under ROC curves were: 0.903 0.017 to osmophobia during crisis; 0.784 0.025 between crises; 0.807 0.023 to photophobia/phonophobia, and 0.885 0.017 to pain developed by odors. Osmophobia may be a specific marker to differentiate migraine from tension-type headache, which suggests its inclusion within the criteria to diagnose migraine.

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